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There is renewed interest in the inverse association between psychiatric hospital and prison places, with reciprocal time trends shown in more than one country. We hypothesised that the numbers of admissions to psychiatric hospitals and committals to prisons in Ireland would also correlate inversely over time (i.e. dynamic measures of admission and committal rather than static, cross-sectional numbers of places).
Publicly available activity statistics for psychiatric hospitals and prisons in Ireland were collated from 1986 to 2010.
There was a reciprocal association between psychiatric admissions and prison committals (Pearson r=−0.788, p<0.001), an increase of 91 prison committals for every 100 psychiatric hospital admissions foregone.
Penrose’s hypothesis applies to admissions to psychiatric hospitals and prisons in Ireland over time (dynamic measures), just as it does to the numbers of places in psychiatric hospitals and prisons in Ireland and elsewhere (static, cross-sectional measures). Although no causal connection can be definitively established yet, mentally disordered prisoners are usually known to community mental health services. Psychiatric services for prisons and the community should be linked to ensure that the needs of those currently accessing care through prisons can also be met in the community.
To systematically review studies from Irish prisons that estimate the prevalence of major mental illness, alcohol and substance misuse, and homelessness at the time of committal.
Healthcare databases were searched for studies quantifying the point prevalence for each outcome of interest. Searches were augmented by scanning of bibliographies and searches of governmental and non-governmental websites. Proportional meta-analyses were completed for each outcome.
We found eight, six and five studies quantifying the point prevalence of major mental illness, substance misuse, and homelessness respectively. Considerable heterogeneity was found for each subgroup (except psychosis where substantial heterogeneity was observed) and random effects models were used to calculate pooled percentages. The pooled percentage for psychotic disorder was 3.6% [95% confidence interval (CI) 3.0–4.2%], for affective disorder 4.3% (95% CI 2.1–7.1%), for alcohol use disorder 28.3% (95% CI 19.9–37.4%), for substance use disorder 50.9% (95% CI 37.6–64.2%) and for those who were homeless on committal 17.4% (95% CI 8.7–28.4%).
Estimates for the prevalence of psychotic illness and substance abuse amongst Irish prisoners are in keeping with international estimates of morbidity in prisons, whilst those for affective disorders are lower. The prevalence of homelessness in committal to Irish prisons is higher than some international estimates. Rates for psychoses, alcohol and substance misuse as well as homelessness in Irish prisons are significantly higher than the general population prevalence of these vulnerabilities. A need for service development is discussed.
The clinical signs of copper (Cu) deficiency are largely non-specific and a number of laboratory tests have been used extensively to assist in diagnosis. Among these are whole blood, plasma and serum Cu and caeruloplasmin (McMurray, 1980). However, for any marker to be useful diagnostically, it is necessary to identify any factors which can affect it. Plasma and serum Cu are not equivalent but are related by the equation:
Serum Cu (mg/l) = 11.7 + 0.66 plasma Cu (mg/l). The regression was obtained from the means of 24 groups of suckler cows and calves (> 10 animals/group). The equivalent relationship between serum and plasma caeruloplasmin is:
Serum caeruloplasmin = 0.0018
+ 0.59 plasma caeruloplasmin.
Units of caeruloplasmin are absorbance units in the phenylene diamine assay.
Thus, the range of normality will depend on the sample being used for the assay. The reduction in serum values is due to the loss of caeruloplasmin during blood clotting.
This study estimates the symptomatology of attention deficit–hyperactivity disorder (ADHD) in adult mental health services (AMHS) outpatient clinics.
All consecutive patients attending any of the outpatients’ clinics in Sligo/Leitrim AMHS were invited to participate. Participants completed the Adult ADHD Self-Report Scale (ASRS) and the Wender Utah Rating Scale (WURS) self-report. Clinical notes were reviewed to identify those with a pre-existing ADHD diagnosis.
From 822 attending the clinics, 62 did not meet inclusion criteria, 97 declined to participate and 29 had incomplete data in either of the screening scales, leaving 634 (77%) eligible for full study analysis. Mean age was 40.38 (s.d.: 12.85), and 326 (51.4%) were females. In total, 215 (33.9%) screened positive on the WURS for childhood onset ADHD and 219 (34.5%) participants scored positive on the ASRS. Applying a more stringent criteria of scoring above cut-offs on both scales, suggested 131 (20.7%) screened positive on both. Only three (2.3%) had a prior clinical diagnosis.
This preliminary study suggests the possibility of relatively higher rates of ADHD in a general AMHS than previously thought, however, given the possibility of overlapping symptoms with other major psychiatric disorders in adulthood and recall bias further research is needed before drawing firm conclusions.
Research on post-traumatic stress disorder (PTSD) course finds a substantial proportion of cases remit within 6 months, a majority within 2 years, and a substantial minority persists for many years. Results are inconsistent about pre-trauma predictors.
The WHO World Mental Health surveys assessed lifetime DSM-IV PTSD presence-course after one randomly-selected trauma, allowing retrospective estimates of PTSD duration. Prior traumas, childhood adversities (CAs), and other lifetime DSM-IV mental disorders were examined as predictors using discrete-time person-month survival analysis among the 1575 respondents with lifetime PTSD.
20%, 27%, and 50% of cases recovered within 3, 6, and 24 months and 77% within 10 years (the longest duration allowing stable estimates). Time-related recall bias was found largely for recoveries after 24 months. Recovery was weakly related to most trauma types other than very low [odds-ratio (OR) 0.2–0.3] early-recovery (within 24 months) associated with purposefully injuring/torturing/killing and witnessing atrocities and very low later-recovery (25+ months) associated with being kidnapped. The significant ORs for prior traumas, CAs, and mental disorders were generally inconsistent between early- and later-recovery models. Cross-validated versions of final models nonetheless discriminated significantly between the 50% of respondents with highest and lowest predicted probabilities of both early-recovery (66–55% v. 43%) and later-recovery (75–68% v. 39%).
We found PTSD recovery trajectories similar to those in previous studies. The weak associations of pre-trauma factors with recovery, also consistent with previous studies, presumably are due to stronger influences of post-trauma factors.
Although mental disorders are significant predictors of educational attainment throughout the entire educational career, most research on mental disorders among students has focused on the primary and secondary school years.
The World Health Organization World Mental Health Surveys were used to examine the associations of mental disorders with college entry and attrition by comparing college students (n = 1572) and non-students in the same age range (18–22 years; n = 4178), including non-students who recently left college without graduating (n = 702) based on surveys in 21 countries (four low/lower-middle income, five upper-middle-income, one lower-middle or upper-middle at the times of two different surveys, and 11 high income). Lifetime and 12-month prevalence and age-of-onset of DSM-IV anxiety, mood, behavioral and substance disorders were assessed with the Composite International Diagnostic Interview (CIDI).
One-fifth (20.3%) of college students had 12-month DSM-IV/CIDI disorders; 83.1% of these cases had pre-matriculation onsets. Disorders with pre-matriculation onsets were more important than those with post-matriculation onsets in predicting subsequent college attrition, with substance disorders and, among women, major depression the most important such disorders. Only 16.4% of students with 12-month disorders received any 12-month healthcare treatment for their mental disorders.
Mental disorders are common among college students, have onsets that mostly occur prior to college entry, in the case of pre-matriculation disorders are associated with college attrition, and are typically untreated. Detection and effective treatment of these disorders early in the college career might reduce attrition and improve educational and psychosocial functioning.
Direct solar flare neutrons are a valuable diagnostic of high-energy ion acceleration in these events, and COMPTEL improves over all previous cosmic neutron detectors in its capacity for neutron energy measurement. Previous studies of COMPTEL neutron data have worked with an incomplete model of the instrumental response, applying energy-by-energy detection efficiencies. Here we employ statistical regularisation techniques with the full (Monte Carlo simulation derived) response matrix to produce improved estimates of neutron numbers and energy distribution. These techniques are applied to data from the well-observed 15 June 1991 flare. Our improved treatment of the instrumental response results in a reduction of 73% in total neutron numbers, compared with previously deduced values. Implications for the picture of primary ion acceleration in this flare are briefly discussed.
To examine barriers to initiation and continuation of mental health treatment among individuals with common mental disorders.
Data were from the World Health Organization (WHO) World Mental Health (WMH) surveys. Representative household samples were interviewed face to face in 24 countries. Reasons to initiate and continue treatment were examined in a subsample (n = 636 78) and analyzed at different levels of clinical severity.
Among those with a DSM-IV disorder in the past 12 months, low perceived need was the most common reason for not initiating treatment and more common among moderate and mild than severe cases. Women and younger people with disorders were more likely to recognize a need for treatment. A desire to handle the problem on one's own was the most common barrier among respondents with a disorder who perceived a need for treatment (63.8%). Attitudinal barriers were much more important than structural barriers to both initiating and continuing treatment. However, attitudinal barriers dominated for mild-moderate cases and structural barriers for severe cases. Perceived ineffectiveness of treatment was the most commonly reported reason for treatment drop-out (39.3%), followed by negative experiences with treatment providers (26.9% of respondents with severe disorders).
Low perceived need and attitudinal barriers are the major barriers to seeking and staying in treatment among individuals with common mental disorders worldwide. Apart from targeting structural barriers, mainly in countries with poor resources, increasing population mental health literacy is an important endeavor worldwide.
The World Mental Health Survey Initiative (WMHSI) has advanced our understanding of mental disorders by providing data suitable for analysis across many countries. However, these data have not yet been fully explored from a cross-national lifespan perspective. In particular, there is a shortage of research on the relationship between mood and anxiety disorders and age across countries. In this study we used multigroup methods to model the distribution of 12-month DSM-IV/CIDI mood and anxiety disorders across the adult lifespan in relation to determinants of mental health in 10 European Union (EU) countries.
Logistic regression was used to model the odds of any mood or any anxiety disorder as a function of age, gender, marital status, urbanicity and employment using a multigroup approach (n = 35500). This allowed for the testing of specific lifespan hypotheses across participating countries.
No simple geographical pattern exists with which to describe the relationship between 12-month prevalence of mood and anxiety disorders and age. Of the adults sampled, very few aged ⩾80 years met DSM-IV diagnostic criteria for these disorders. The associations between these disorders and key sociodemographic variables were relatively homogeneous across countries after adjusting for age.
Further research is required to confirm that there are indeed stages in the lifespan where the reported prevalence of mental disorders is low, such as among younger adults in the East and older adults in the West. This project illustrates the difficulties in conducting research among different age groups simultaneously.
This paper is concerned with a stochastic model for the spread of an epidemic with a contact tracing scheme, in which diagnosed individuals may name some of their infectious contacts, who are then removed if they have not been already. Traced individuals may or may not also be asked to name their own contacts. The epidemic is studied by considering an approximating, modified birth-death process with intersibling dependencies, for which a threshold parameter and expressions from which extinction probabilities may be calculated are derived. When all individuals can name their contacts, it is shown that this threshold parameter depends on the infectious period distribution only through its mean. Numerical studies show that the infectious period distribution choice can have a material effect on the threshold behaviour of an epidemic, while the dependencies help reduce spread.
Pulsed laser deposition has been used to fabricate thin-film capacitor structures in which the dielectric layer is composed of a superlattice of Ba0.8Sr0.2TiO3 and Ba0.2Sr0.8TiO3. The properties of the capacitors were investigated as a function of superlattice periodicity. The dielectric constant was significantly enhanced, and temperature migration of the peak in dielectric constant as a function of frequency was observed, at stacking periodicities of a few unit cells. However, such ‘relaxor-like’ features were found to be associated with high dielectric loss. Analysis of the imaginary permittivity as a function of frequency showed that fine-scale superlattices conform to Maxwell-Wagner behaviour, indicating that the observed features may be an artefact of increased carrier mobility. Modelling showed that both dielectric enhancement and frequency relaxation could readily be reproduced by Maxwell-Wagner formalism.
Pulsed laser deposition has been used to fabricate thin-film capacitor structures in which the dielectric layer is composed of a superlattice of Ba0.8Sr0.2TiO3 and Ba0.2Sr0.8TiO3. The properties of the capacitors were investigated as a function of superlattice periodicity. The dielectric constant was significantly enhanced, and temperature migration of the peak in dielectric constant as a function of frequency was observed, at stacking periodicities of a few unit cells. However, such “relaxor-like’ features were found to be associated with high dielectric loss. Analysis of the imaginary permittivity as a function of frequency showed that fine-scale superlattices conform to Maxwell-Wagner behaviour, indicating that the observed features may be an artefact of increased carrier mobility. Modelling showed that both dielectric enhancement and frequency relaxation could readily be reproduced by Maxwell-Wagner formalism.
Pulsed laser deposition has been used to fabricate thin-film capacitor structures in which the dielectric layer is a superlattice. The properties of two superlattice systems were investigated as a function of superlattice wavelength (δ) – one based on barium strontium titanate and the other on lead-based relaxor electroceramics. In both systems the dielectric constant was significantly enhanced at stacking wavelengths of a few unit cells. However, the dielectric enhancement seen in the barium strontium titanate superlattices was found to be due to Maxwell-Wagner effects, whereas in the relaxor superlattices Maxwell-Wagner behaviour was not evident; rather, the dielectric enhancement was associated with the onset of polar coupling aroundδ ∼ 10nm.